Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Wilderness Medicine in a Global Health Care Setting

This is the next post based upon a presentation given at the Wilderness Medical Society Annual Meeting held in Snowmass, Colorado from July 24-29, 2009. The presentation was entitled “Wilderness Medicine in a Global Health Care Setting.” It was delivered by Irwin From.

The skill sets and expertise of wilderness medicine practitioners serve well during times of disaster and for global humanitarian relief, because these are situations that often require improvisation and the ability to make due in austere environments. Much of the information for this presentation was derived from the work of Medical Missionaries, a 501c3 non profit volunteer organization dedicated to providing health care for the poor. This organization is intent on applying its skills to provide infrastructure and to promote continuity of its efforts.

The presenter was of the opinion that wilderness medicine equals third world medicine. In that analogy, he noted that often, the objective is to get an equipped, prepared medical team to function in a remote, rural setting, then to assess the status of health in the population. As part of this process, he observed that the following considerations would be invoked: physical conditioning, team immunizations and disease (e.g., malaria) prophylaxis, and provision of food, water and shelter. As for any foray into a foreign country, one needs to be prepared for how much equipment and supplies are allowed during entry, customs requirements (including medication expiration dates and perhaps “gratuity tax”), lodging within country, vehicle preparations, pack animals, guides and maps, proper clothing, hazardous terrain, route finding, group dynamics, communications and so forth.

When traveling and working within a foreign country, it is essential to be familiar with rules and customs, and helpful to be able to manage common environmental hazards. One should, for instance, be able to swim. Individuals must be in shape and acclimatized to the environment if necessary. In the absence of undue risk to team members, it is often strategic to have female members, with whom the local population may be more comfortable and forthcoming than with males.

Useful technologies might include a field laboratory and simple test equipment, particularly of the rapid testing variety. Medications and instruments are tailored to the mission, including the common and uncommon diseases that might be encountered. One must always keep in mind the ubiquity, severity and problematic nature of dental problems, as well as complications of pregnancy and third world infectious diseases, such as tuberculosis. Finally, malnutrition is common, so practitioners should be familiar with the presentation of various nutritional deficiencies. These are problems not commonly seen in developed countries.

In this new year, let us follow the numerous examples of humanitarianism and pledge once again to offer relief to those in need.

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.